This article appeared in Canadian Healthcare Facilities magazine, Spring 2023
Smart buildings, smart cities, Internet of Things (IoT), 5G, digital twins, single panes of glass. The healthcare industry is full of tech buzz words and the challenge for facilities is to figure out how to leverage these technologies, and to optimize existing and future infrastructure. More than ever, the adoption and integration of technology can help ease the immense strain on healthcare facilities in Canada.
IoT is a relatively mature technology in the industrial and manufacturing sectors. These highly process-driven environments benefit greatly from incremental change and process improvement that is to be gained from collecting and analyzing data.
Healthcare facilities are starting to incorporate smart building technology into new build projects; however, there is limited integration with existing facilities, even with major retrofits/renovations. Much like industrial and manufacturing, healthcare is also a highly process-driven sector and it stands to reason that facilities can benefit from IoT technology in much the same way.
HH Angus has been working closely with a health network in the Greater Toronto Area to explore the use of IoT for space optimization. The engineering and consulting firm was tasked with finding use cases that could show value for the health network. Following a series of discussions, a variety of different use cases were identified around gathering data for presence and space utilization within clinical and administrative spaces.
Healthcare facilities’ needs change over time and spaces within existing facilities are often repurposed to meet evolving requirements. It is also of paramount importance that existing space is used in an optimal way. With this in mind, two short-term data collection use cases were developed along with one long-term use case. The ultimate goal in all cases was to use data to drive decision-making.
The short-term use cases looked at near real-time data acquisition to examine clinical space usage on a room-by-room resolution, as well as historical data analysis to optimize the distribution of administrative spaces.
Current space usage data comes from the healthcare facility’s health information system; alternatively, data is gathered by direct observation of a space within the facility. Using simple wireless infrared-based presence sensors and a custom dashboard, the HH Angus team was able to visualize specific data on how a clinical space was occupied throughout the day. By grouping data from similar room types, hourly, daily and weekly trends could be easily seen.
While this data was interesting, it lacked true insight. Healthcare facilities can look at the various data sets but a user would need to spend time sifting through it in order to make observations based on this data.
As the data collection continued, HH Angus and the healthcare facility looked at the individual usages within similar room type groupings to determine if any difference could be observed. There was anecdotal feedback from the clinicians that there would be distinctions. For instance, many of the blood draw rooms were used at a significantly higher rate than other rooms. From a functional perspective, these are adjacent rooms with no specific differences. This begs the questions: Why are patients assigned to the blood draw rooms at different rates? And where is this bias originating? Ultimately, in the short-term, there is no impact on the function of the space but long-term, there is more wear and tear on building assets due to the uneven distribution in usage. Could a change in procedure at the clinical level remove this bias? Or could changes to the functional program prevent this bias in future?
Based on learnings from the first use case, the second short-term use case had a very specific goal. The healthcare facility wanted to understand the overall usage for various administrative spaces. Typically, there is limited data available for administrative space usage. A healthcare facility can harvest card reader data, which is a viable data source for this use case; however, it is limited to areas that have controlled access. Not all areas have card reader data available. Further, card reader data needs to be anonymized and it does not account for tailgaters.
The healthcare facility considered the collection of accurate data important, as the current understanding of space usage came from anecdotal observation and feedback from departments occupying the spaces. Hybrid and remote working due to COVID-19 had fundamentally changed how administrative spaces were being used, and the healthcare facility felt there was opportunity to optimize how spaces across their campus could be utilized.
Again, using a custom data visualization, historical data on administrative space usage was displayed with specific insights on, for example, most favoured days of the week, and the three most and least popular days in a given time period that could be used to make data-driven decisions on space usage.
With this data, the healthcare facility can work with the various departments occupying the space to determine if there are options to reorganize, reschedule or combine departments.
The final use case looked at long-term space utilization. When it comes to a new build, the functional programming is a complex challenge that needs to be solved. Functional programming is largely driven by design architects and the clinicians who will be using the space. Both these groups have valuable insight into the spaces, particularly clinicians who want to improve how their existing spaces operate and are programmed. However, by gathering data over a long period to inform future space planning and functional programming, the current process for functional programming and space design can be strengthened with real data. This could be applied when planning a large infrastructure renewal or major retrofit.
There is incredible potential for IoT technology to improve healthcare facilities. The healthcare sector is at the tip of the iceberg in making data-driven decisions as it relates to space usage. As project experience confirms, the focus should be on making sure the right questions are asked to derive the correct use cases to drive value. As vital as the technology is to gathering data, it is secondary to determining the right use case and application. With immense pressure on health systems, engineers can still find new ways to help solve problems and challenges facing Canadian healthcare facilities.